Below is helpful information regarding what to expect when paying for behavioral health care services.
Paying for Outpatient Treatment
If you have insurance
- Partial Hospitalization Programs (PHP) and Intensive Outpatient Programs (IOP):
- Many programs bill you when you finish the program; if you can’t pay all at once you can ask about payment plan options before starting treatment
- Your insurance plan may cover these treatments; the staff will talk to you about your coverage before you start treatment
- Psychiatrists and therapists:
- Expect to pay your co-pay at each appointment
- If your insurance is not accepted you may still get reimbursed from your insurance company if you have Out-of-Network Reimbursement Benefits; call the customer service number on your insurance card to find out if your insurance company will pay you back
- If your employer offers an Employee Assistance Program (EAP) you may be able to get a certain number of free sessions with a therapist
- If you have questions or concerns about payment, you should discuss them with your therapist or psychiatrist
- Average co-pay costs for outpatient treatment:
- PHP: approximately $25 – $100 a day
- IOP: approximately $25 – $80 a day
- Psychiatrists: approximately $15 – 60 per session
- Therapists: approximately $10 – $60 per session
- Support groups: most are free
If you are uninsured
- Partial Hospitalization Programs (PHP) and Intensive Outpatient Programs (IOP):
- Many programs bill you when you finish the program; if you can’t pay all at once you can ask about payment plan options before starting treatment
- Ask if the program offers financial assistance
- Remember to inquire about payment options BEFORE starting treatment
- The average daily cost can range from $300 – 400 per day without insurance
- Psychiatrists:
- Initial evaluations usually cost between $250 – $350 and follow-ups are $100 to $200 for 30- to 60-minute sessions
- Payment is expected at each appointment
- Remember to inquire about payment options BEFORE starting treatment
- Therapists:
- Some therapists offer sessions at a lower rate called “sliding scale fees”; ask about this when you schedule an appointment
- In bigger cities there are often non-profit agencies that offer counseling services for the uninsured or underinsured
- For referrals in Central Texas, contact 211 or a Ascension Seton Behavioral Health Navigator at 512-324-2039
- Uninsured financial help:
- If you are uninsured and cannot pay the full fee to see a psychiatrist or therapist, most communities have state or city funded agencies or Community Mental Health Centers (CMHC) that may be able to help
- To find a CMHC, call 211 or search online
- In some cities, you can find non-profit agencies that offer counseling services
- Be aware that you may have to go through a screening process and these agencies may have waiting lists
- These clinics often take Medicare, Medicaid, MAP (Travis County) and marketplace insurance plans
- For referrals or more information about services in Central Texas, contact 211 or a Ascension Seton Behavioral Health Navigator at 512-324-2039
Paying for Inpatient Treatment
If you have insurance
- Acute inpatient treatment is often covered or partially covered by insurance, including Medicare; you have the right to know what will be covered and what you will have to pay
- The hospital or facility will help check your insurance coverage before you are admitted; this is a good time to ask about payment plans
- Many insurance companies require “pre-certification,” which means that the hospital staff will give your insurance company information about why you need treatment to make sure your hospital stay will be covered
- Contact customer service at your insurance company to seek answers to the following important treatment questions:
- What facilities are in-network? What facilities are out-of-network? What is the difference in cost?
- Are there limits on how long I can be in the hospital or in residential treatment? Are there limits on how often I can be in the hospital or in residential treatment?
- Am I required to use a facility that is “accredited?” (Accreditation means the treatment facility meets the standards of the accrediting group; you can check to see if the facility is accredited at
findtreatment.samhsa.gov/locator/home.)
- Average co-pay:
- Psychiatric Emergency Room: approximately $100 per visit
- Acute hospitalization, including detox: approximately $175 – $750 per day (some insurance companies may pay a percentage of the co-pay after you have reached your out of pocket maximum; some may also limit the number of days they will pay for in a year, ranging from five to 30 days)
- Residential treatment: approximately $175 – $750 per day
If you are uninsured
- Many communities in Texas have options for financial support or community-based detox programs; in Central Texas OSAR (Outreach, Screening, Assessment and Referral) can be reached by calling 1-877-9-NO-DRUG
- Some psychiatric hospitals and residential facilities will offer options for financial assistance for the needed treatment
- Most hospitals or facilities will also have an option for private pay, meaning that you do not have to have or use insurance to cover the costs